title: Quality measurement and benchmarking of HPV vaccination services: a new approach.
abstract: BACKGROUND
  A new measurement process based upon a well-defined mathematical model was applied to evaluate the quality of human papillomavirus (HPV) vaccination centers in 3 of 12 Local Health Units (ASLs) within the Lazio Region of Italy. The quality aspects considered for evaluation were communicational efficiency, organizational efficiency and comfort.
  
  
  RESULTS
  The overall maximum achievable value was 86.10%, while the HPV vaccination quality scores for ASL1, ASL2 and ASL3 were 73.07%, 71.08%, and 67.21%, respectively.
  
  
  CONCLUSIONS
  With this new approach it is possible to represent the probabilistic reasoning of a stakeholder who evaluates the quality of a healthcare provider. All ASLs had margins for improvements and optimal quality results can be assessed in terms of better performance conditions, confirming the relationship between the resulting quality scores and HPV vaccination coverage.
  
  
  METHODS
  The measurement process was structured into three steps and involved four stakeholder categories: doctors, nurses, parents and vaccinated women. In Step 1, questionnaires were administered to collect different stakeholders' points of view (i.e., subjective data) that were elaborated to obtain the best and worst performance conditions when delivering a healthcare service. Step 2 of the process involved the gathering of performance data during the service delivery (i.e., objective data collection). Step 3 of the process involved the elaboration of all data: subjective data from step 1 are used to define a "standard" to test objective data from step 2. This entire process led to the creation of a set of scorecards. Benchmarking is presented as a result of the probabilistic meaning of the evaluated scores.
authors.affiliation: Department of Biomedicine and Prevention and Specialization School for Hygiene and Preventive Medicine; University of Rome "Tor Vergata" (Italy); Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Maurici
authors.affiliation: A.Fa.R.; Fatebenefratelli Association for Biomedical Research; Rome, Italy; Department of Basic and Applied Sciences in Engineering (SBAI); School of Doctorate in Mathematical Methods and Models for Society and Technology; University of Rome "Sapienza" (Italy); Rome, Italy; QOLITY Design Ltd; Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Paulon
authors.affiliation: A.Fa.R.; Fatebenefratelli Association for Biomedical Research; Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Campolongo
authors.affiliation: Department of Biomedicine and Prevention and Specialization School for Hygiene and Preventive Medicine; University of Rome "Tor Vergata" (Italy); Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Meleleo
authors.affiliation: Department of Biomedicine and Prevention and Specialization School for Hygiene and Preventive Medicine; University of Rome "Tor Vergata" (Italy); Rome, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Carlino
authors.affiliation: A.Fa.R.; Fatebenefratelli Association for Biomedical Research; Rome, Italy; QOLITY Design Ltd; Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordani
authors.affiliation: Agency for Public Health (ASP-Laziosanità); Lazio Region; Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Perrelli
authors.affiliation: Local Health Unit (ASL) RMF; Lazio Region, Civitavecchia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sgricia
authors.affiliation: A.Fa.R.; Fatebenefratelli Association for Biomedical Research; Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ferrante
authors.affiliation: Department of Biomedicine and Prevention and Specialization School for Hygiene and Preventive Medicine; University of Rome "Tor Vergata" (Italy); Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Franco
mesh_terms: D000293:Adolescent; D000328:Adult; D019985:Benchmarking; D002648:Child; D005260:Female; D006298:Health Services Administration; D006302:Health Services Research; D006801:Humans; D007558:Italy; D008875:Middle Aged; D008962:Models, Theoretical; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010865:Pilot Projects; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: comfort; communicational efficiency; human papillomavirus vaccination; organizational efficiency; probability theory; quality indicators